Systems and methods for remotely controlling robotic-assisted medical procedures

This disclosure relates generally to approaches for remotely controlling robotic-assisted medical procedures, such as surgical procedures.

Robot-assisted surgery systems are generally available and have been developed to operate efficiently and safely. A robotic surgery system typically includes robotically actuable surgical instruments that may be inserted within the patient's body to perform a surgical procedure at a physician site. The robotic surgery system is typically controlled by a physician via a physician input console, which is connected to the robotic surgery system via a control cable. The physician input console includes input devices that are grasped by the physician's hands and moved to generate signals for activating the surgical instruments to perform surgical operations at the surgical site. Signals are transmitted over the control cable to the robotic surgery system, which interprets the signals and generates control signals that cause the instruments to be actuated to perform surgical operations.

For physicians or other medical professionals, advantageously, remote procedures facilitate optimal utilization of their time and provide access to a sufficient volume of patients to perfect their skills. For patients, advantageously, remote procedures create ample access to the right physician or medical professional and the right care at an affordable price, decreases the need for travel, and reduces delayed care. Approaches described herein can provide a secure network environment for health system administrators, robotic system manufacturers, and super users to access, manage, and manipulate various components of robotic-assisted medical systems that can be controlled remotely. Disclosed approaches facilitate patient safety and increase the effectiveness and availability of remotely controlled robotic procedures.

Disclosed systems, apparatuses, and methods enable remotely controlling robotic-assisted medical systems, such as robotic-assisted surgery systems, via an access monitoring management system (sometimes referred to as AAMS). Various different levels of user privileges can be utilized to allow different entities different levels of access to robotic-assisted medical systems that can be controlled remotely. Such disclosed approaches provide a scalable, flexible, and efficient hierarchy for controlling the operation of robotic-assisted medical systems that can be controlled remotely.

Other aspects and features will become apparent to those ordinarily skilled in the art upon review of the following description of specific disclosed implementations in conjunction with the accompanying figures.

1 FIG. 100 100 102 108 102 108 102 108 110 100 100 112 114 100 118 114 116 116 102 108 118 100 102 108 114 112 114 116 118 114 100 102 108 100 118 Referring to, a robotic medical procedure system, in particular, a robotic surgery system is shown generally at. The robotic surgery systemincludes a plurality of robotically actuable surgical instruments-positioned on one or more robotic arms. At least one of the instruments-will generally be configured as an in-patient imaging system (such as, a camera, fluoroscopy system which can obtain a continuous X-ray image, radiography system, computer tomography (CT) system, ultrasound system, magnetic resonance imaging (MRI) system, or the like), which may be inserted into the body of the patient to generate images of anatomical structures and the surgical instruments-at a surgical site within the body of a patient. In some instances, a plurality of imaging systems can be utilized by the robotic surgery system. In some cases, one or more imaging systems may not need to be inserted into the patient's body. The remaining instruments may be configured to include an end effector that performs a specific surgical function (such as, forceps/graspers, needle drivers, scissors, electrocautery hooks, staplers, clip appliers, removers, etc.). The systemis controlled by a surgeonvia a surgeon input console, which is connected to the robotic surgery systemvia a control cable. The surgeon input consoleincludes input devices (not shown) including handlesthat are grasped by the surgeon's left and right hands and moved within an input device workspace or otherwise actuated to generate input signals. The input devices include encoders that transform positions and orientations of the handlesinto input signal data representing the surgeon input. The input signals may thus be used for activating the plurality of surgical instruments-to perform surgical operations at the surgical site. The input signals are transmitted over the control cableto the system, which interprets the signals and generates control signals that cause the instruments-to be actuated to move and perform other surgical operations. The input signals will generally be output by the input devices on the surgeon input consoleas data signals representing the inputs to the console provided by the surgeon. For example, the surgeon input consolemay generate input signals in the form of motion control signals that represent instantaneous positions of the handlesof the input devices within an input device workspace. The data signals are transmitted over the control cable, which is generally a wired connection between the surgeon input consoleand the robotic surgery system. The wired connection ensures negligible transmission delay such that operations of the surgical instruments-caused by the surgeon will be effected by the systemwith negligible delay. Transmission over the control cablemay be implemented using any of a variety of different data transmission technologies such as Ethernet or Controller Area Network (CAN bus) protocol.

100 100 The robotic surgery systemcan include a patient cart that supports the robotic arms. In some instances, a separate vision cart that supports one or more imaging systems can be included. The robotic surgery systemcan also include a tower that serves as a central hub to which the patient cart and vision cart (if present) are connected. Any network connections to the robotic surgery system described herein can be made to the tower.

114 116 102 108 114 102 108 100 100 114 112 Additional input signals may also be generated at the surgeon input console. For example, the handlesmay include other controls (not shown) that may be used to generate actuation signals that actuate operations at the surgical instruments-, such as opening or closing a surgical scissor or forceps. The surgeon input consolemay also include one or more foot pedals (not shown) that may be actuated by the surgeon to initiate various other operations. For example, a foot pedal may be configured to generate a clutch signal for temporarily decoupling the surgical instruments-. A foot pedal may also be configured to initiate delivery of energy, such as generate electrocautery signals for initiating delivery of an electrocauterization current to an instrument, to cut, cauterize, or coagulate tissue (which can involve resection of tissue, vaporization of tissue, or coagulation of tissue). Delivery of energy can include delivery of ultrasonic energy (such as, with a harmonic scalpel instrument), delivery of electric energy (such as, with an electrocautery instrument), delivery of laser energy (such as, with a cautery instrument), delivery of radio frequency energy (such as, with a cautery instrument), or the like. These other input signals also need to be delivered to the robotic surgery systemto initiate their respective operations. Additionally, the robotic surgery systemmay generate event-oriented notifications such as notifications of error conditions that must be communicated to the physician input consoleto update the physician. Event-oriented messages may be time-sensitive, but are not necessarily synchronous.

114 120 120 122 114 120 122 112 102 108 The physician input consolealso includes a displayfor displaying images generated by the in-patient imaging system. The in-patient imaging system would generally be implemented as a high-resolution imaging system (such as, a video camera) that generates a stream of image frames. In some instances, the imaging system may generate images from differing perspectives that convey three-dimensional information and the displaymay be configured as a stereoscopic display. The display signals generated by the imaging system are transmitted over an image transmission cableback to the physician input consolefor driving the display. The image transmission cableis generally selected to ensure that the image frames are delivered to the display in near real-time so that the physiciandoes not perceive any delay between their hand movements and movements of the surgical instruments-represented on the display. In some implementations, the input signals and display signals may both be transmitted over a single shared cable or bus.

115 100 114 115 118 122 115 100 114 115 115 1 FIG. A connectioncan be used for transmission of data between the robotic surgery systemand the surgeon input console. As illustrated in, the connectioncan utilize the control cableand the image transmission cable. The connectioncan be a direct connection that links the robotic surgery systemand the surgeon input console. The connectioncan be isolated from any other network. For instance, the connectioncan be a direct local area network (LAN) connection.

100 102 108 114 118 122 114 100 110 114 100 118 122 100 114 120 The robotic surgery systemmay be housed within a sterile operating room that forms part of an operating suite. The surgeon or another surgeon aided by a perioperative nurse may make the necessary incisions and insert the instruments-. The surgeon input consolemay be housed in a portion of the operating suite that is separated from the operating room so that the surgeon operating the input console need not wear surgical gloves while manipulating the controls of the input console. The cablesandwould generally extend through a port in a wall between the surgeon input consoleand the robotic surgery system. In cases where another surgeon performs the incisions in the body of the patient, the operating surgeon may not need to complete the full process of scrubbing, gowning, and gloving before the operation. In this situation, the surgeon input consolehowever remains in a direct wired connection with the robotic surgery systemvia the cablesand. The direct wired connection ensures that the robotic surgery systemis able to rapidly respond to the surgeon's inputs provided at the surgeon input consoleand the displaydisplays images of the surgical site with a negligible delay that is virtually unnoticeable to the surgeon.

Overview of Remotely Controlling Robotic Procedures

While certain examples are described in the context of remotely controlling a surgical procedure performed by a robotic surgery system, the approaches described herein can be used for remotely controlling a variety of medical procedures, including invasive and non-invasive procedures as well as surgical and non-surgical procedures. The approaches described herein can be used for remotely controlling surgical procedures, interventional procedures, or diagnostic procedures (such as, procedures not involving manipulation of tissue). Medical procedures can be performed by patient-side robotic procedure systems that are controlled by physician-side robotic procedure consoles. Patient-side robotic procedure systems can have one of more features of the robotic surgery systems described herein, such as one or more of an imaging system on a robotic arm or an instrument on a robotic arm. Physician-side robotic procedure consoles described herein can have one or more features of the input consoles described herein, such as one or more displays and input devices.

2022 100 One of the main problems in the healthcare industry is the lack of physicians (for instance, surgeons) and their underutilization. On one hand, there is a lack of high-quality physicians. For instance, aarticle by the American College of Surgeons concludes that there is an acute ongoing shortage of surgeons available in the United States to serve the patient population. The shortage of high-quality surgical care is particularly severe in rural areas. In addition, surgeons in many geographical areas may not have access to a sufficient volume of patients to perfect their surgical skills because the population is not evenly distributed, thus creating a lack of surgical volume in such areas. On the other hand, currently there are severe inefficiencies with utilizing the time of physicians. For instance, surgeons are required to travel between different hospitals, some of which may be located in difficult to reach places or between different operating rooms in a single hospital. Moreover, surgeons are required to wait for patients and operating rooms to be prepared for surgery. This results in a serious underutilization of surgeons' time. There are many advantages in allowing surgeons to control robotic surgery systems (such as, the system) from remote locations in order to increase efficiency and improve patient care. For surgeons, remote surgery facilitates optimal utilization of their time and provides access to a sufficient volume of patients to perfect their skills. For patients, remote surgery creates ample access to the right surgeon and the right care at an affordable price, decreases the need for travel, and decreases delayed care. However, there are a number of challenges with designing a system that would allow remotely controlling robotic surgery systems. These include transmission delay, availability, and reliability of transmission.

2 FIG. 1 FIG. 114 200 100 202 200 202 100 114 200 200 202 208 115 114 100 Referring to, the surgeon input consoleis disposed at a surgeon-side locationand the robotic surgery systemshown inis disposed at a patient-side location. The surgeon-side locationis remote from the patient-side locationto an extent where a directly wired connection between the robotic surgery systemand the surgeon input consoleis no longer possible. Advantageously, the surgeon-side locationmay be in another building or even another city, state, or country. In this example, communication is performed between the surgeon-side locationand the patient-side locationvia a network, and there is no direct connectionbetween the surgeon input consoleand the robotic surgery system.

3 FIG. 3 FIG. 1 FIG. 3 FIG. 200 202 204 206 204 114 114 308 116 102 108 100 116 102 108 116 102 108 102 108 114 100 308 114 100 114 308 Referring to, communication between the surgeon-side locationand patient-side locationare conducted via a surgeon-side interfaceand a patient-side interface, which are shown schematically in. The surgeon-side interfaceis connected to receive input signals from the surgeon input console. For example, the surgeon input consolemay generate a stream of motion input signalsthat represent the instantaneous position of the handleswithin an input console workspace. Motion input signals can represent a desired movement (including position and velocity) of an instrument in the input console workspace. These motion input signals will generally be transformed via kinematic processing into signals representing desired positions and orientations of the joints of the instruments-within a surgical workspace of the robotic surgery system. In some instances, kinematic processing translates the position and movement of the handleswithin the input console workspace into the position and movement of joints of the instruments-. The translation can be performed by transforming the position and orientation of the handlesin the Cartesian coordinate system to the coordinates of the joints of the instruments-in the surgical workspace and vice versa. Other processing functions may then be used to transform these kinematically derived instrument joint positions into drive signals for actuating various actuators, such as motor servos, that cause movement of the instruments-within the surgical workspace. In the system shown in, the kinematic and other processing may be implemented within the surgeon input consoleor the within robotic surgery system. In the implementation of, the input signalscan be picked up directly from the input devices of the surgeon input consoleand before any kinematic or other processing has been performed. For some robotic surgery system, the input signals are generated by the input devices of the surgeon input consoleat a relatively low frequency (or rate of change), for example about 200 Hz or every 5 milliseconds or about 30 Hz or less. The input signalsthus require a relatively low bandwidth or data rate for transmission. In contrast, post-kinematics and other processing signals may have a significantly higher frequency (or rate of change). As an example, in some robotic surgery systems the servo rate at the motor controller may be in the region of about 10 kHz or more, which may require a significantly higher bandwidth or data rate for transmission than the motion input signals generated at the input device.

204 206 102 108 308 204 206 102 108 100 102 108 204 308 In general, remotely controlling a robotic surgery system can be achieved by transmitting from the surgeon-side interfaceto the patient-side interfacea complete set of signals that control the instruments-(which include at least one imaging system). Such signals may be referred to as control signals. To reduce delay and guarantee reliability of the transmission, such set of signals can include signals having the lowest frequency (or rate of change) among a plurality of available signals. As described above, input signalscan be transmitted from the surgeon-side interfaceto the patient-side interface, rather than signals generated as a result of kinematic processing that generates signals representing desired coordinates of the joints of the instruments-in the surgical workspace associated with the robotic surgery systemor the drive signals (such as, torque) for actuating the motors of the instruments-. In some cases, the surgeon-side interfacecan select input signalsfor transmission from the plurality of available signals, which can include signals generated as a result of kinematic processing and the drive signals.

204 206 308 In certain implementations, one or more signals generated as a result of kinematic processing may be transmitted by the surgeon-side interfaceto the patient-side interface. These signals can be transmitted along with the input signals.

204 206 208 206 100 202 306 102 108 306 206 208 204 204 208 204 204 114 120 114 112 120 116 114 206 The physician-side interfaceis in communication with the patient-side interfaceover the network. The patient-side interfaceis in communication with the robotic surgery systemfor receiving and delivering control signals to the robotic surgery system. The patient-side locationalso includes an in-patient imaging system, which generates images of the surgical site within the patient. As described above, one of the surgical instruments-may be configured to generate the in-patient images or a separate imaging system may be employed. The in-patient imaging systemgenerates data representing image frames, which is encoded into an image data stream by the patient-side interfaceand transmitted over the networkto the physician-side interface. Image data can be encoded using hardware circuitry of the patient-side interface, such as one or more processors, one or more graphics processing units (GPUs), one or more field-programmable gate arrays (FPGAs), or one or more application-specific integrated circuits (ASICs). Image data can include different types of images obtained by different imaging systems. For example, image data can include endoscopic image (or video) data and X-ray images obtained by a fluoroscopy imaging system. Image data can alternatively or additionally include X-ray images obtained by a radiography imaging system, CT images obtained by a CT imaging system, ultrasound images obtained by an ultrasound imaging system, or MRI images obtained by an MRI imaging system. Different types of image data can be encoded into the image data stream for transmission over the networkto the physician-side interface. The physician-side interfacereceives and decodes the image data stream to recover the image frame data, which is sent via the physician input consoleto the displayassociated with the physician input console. The physicianis able to view the surgical site on the displayand cause movements of the handlesof the physician input console, which are encoded by the input devices and delivered as control signals to the patient-side interface.

100 112 102 108 102 108 116 114 112 114 112 102 108 206 204 114 The robotic surgery systemmay be additionally configured to generate haptic feedback and/or force feedback signals. In robotic surgery, haptic feedback signals may be generated to alert the physicianwhen an attempt is made to move one of the instruments-against an instrument movement boundary or other impediment to motion. Haptic signals may also be generated when two of the instruments-are moved toward a collision condition. These haptic signals are generally used to deliver haptic feedback via the handlesof surgeon input consolethat alert the surgeonto the condition. Additionally, some robotic systems may also be configured to generate force feedback signals that can be used to deliver force feedback to the surgeon via the input console. The force feedback may serve to indicate that the surgeonis attempting to move one of the instruments-against a limitation such as human tissue or an organ. In some implementations the patient-side interfacemay be configured to receive the haptic or force feedback signals and transmit the signals back to the surgeon-side interfacefor delivery to the surgeon input console.

208 208 208 204 100 202 208 The networkmay be provided as a connection to the Internet. In some cases, the networkmay be a dedicated network such as a point-to-point fiber or a specially-conditioned and monitored network that aims to reduce transmission delay and increase reliability and stability. The networkcan be a wide-area network (WAN). The surgeon-side interfaceis in communication with the robotic surgery systemat the patient-side locationvia the network.

304 208 304 A data storecan be included in communication with the network. The data storemay be used as remote network storage for storing data logs and other information connected with surgical operations performed by the systems shown.

100 202 200 200 200 204 200 The robotic surgery systemmay from time-to-time generate event-oriented notifications at the patient-side location. Each event-oriented notification at the patient-side locationmay be processed to generate a notification record including a timestamp indicating a time at which the event-oriented notification was generated, status information including information indicating a processing status of the event-oriented notification, and timeout information including information indicating an expiry time by which the event-oriented notification should be processed. These notification records are then transmitted to the surgeon-side location. At the surgeon-side location, each notification record is received and accumulated for processing. When the status in the notification record indicates that the notification record has not yet been communicated to the surgeon input console and the expiry time in the timeout information exceeds the current time at the surgeon-side location(for instance, as maintained by the surgeon-side interface), an alert is generated. When the status indicates that the notification record has not yet been communicated to the surgeon input console and the expiry time does not yet exceed the current time at the surgeon-side location, a notification message is generated and communicated to the surgeon input console. The status in the notification record is then changed to indicate that the notification record has been processed.

100 300 206 100 206 In some implementations, the robotic surgery systemmay be expecting the control signals to be provided at a certain threshold rate (such as, the rate of a patient-side synchronization signal (PSS) signal). When the control signals received by the robotic surgery system do not satisfy such threshold rate, the patient-side interfacecan repeat at least some of the received control signals or otherwise modify the control signals in order to provide the control signals to the robotic surgery systemat the threshold rate. The threshold rate may not be satisfied as a result of control signals not being received by the patient-side interfaceat a sufficient rate (because of, for instance, network delay) or due to one or more control signals having been discarded, among others.

100 114 100 114 202 204 204 204 In certain cases, the robotic surgery systemcan transmit acknowledgment information to the surgeon input console, for instance, in response to receiving control signals. Acknowledgment information can be transmitted as an acknowledgment signal or message. For example, the robotic surgery systemmay acknowledge each control signal message or packet with an acknowledgment message. The surgeon input consolemay be expecting the acknowledgment message to be provided at a certain threshold rate (for instance, corresponding to the rate of transmission of packets to the patient-side location). When the acknowledgment messages received by the surgeon input console do not satisfy such threshold rate, the surgeon-side interfacecan repeat at least some of the received acknowledgment messages or otherwise modify the acknowledgement messages in order to provide the acknowledgment messages to the surgeon-side interfaceat the threshold rate. The threshold rate may not be satisfied as a result of acknowledgment messages not being received by the surgeon-side interfaceat a sufficient rate (because of, for instance, network delay) or due to one or more acknowledgment messages having been discarded, among others.

204 114 114 114 204 114 416 512 204 5 FIG. The surgeon-side interfacecan be integrated with the surgeon input console, which can encompass being wholly separate from the surgeon input consoleor being wholly or partially a portion of the surgeon input console. In some implementations, the surgeon-side interfacecan be implemented as software and/or firmware being executed by one or more processors of the surgeon input console. For instance,illustrates a surgeon input consolethat implements software and/or firmware interfacethat provides functionality of the surgeon-side interface.

206 100 100 100 206 100 422 422 514 206 5 FIG. The patient-side interfacecan be integrated with the robotic surgery system, which can encompass being wholly separate from the robotic surgery systemor being wholly or partially a portion of the robotic surgery system. In some implementations, the patient-side interfacecan be implemented as software and/or firmware being executed by one or more processors of the robotic surgery system. For instance,illustrates a robotic surgery system(or robot) that implements a software and/or firmware interfacethat provides functionality of the patient-side interface.

System for Remotely Controlling Robotic Procedures

4 FIG. 400 400 402 412 414 415 416 114 416 418 204 419 illustrates a schematic view of a remote robotic-assisted medical system. The systemcan include one or more physician siteseach having one or more computing devices(such as, one or more physician personal computers (PCs)), one or more monitors(which can be connected to the one or more physician PCs), one or more physician-side connectivity clients, one or more robot control and display systems(which can be, for instance, same as or similar to the surgeon input consoleand can be referred to as the physician input console), one or more physician-side adapters(which can be, for instance, same as or similar to the surgeon-side interface), and a physician-side gateway. Any of the computing devices described herein can be mobile or portable.

400 404 420 422 100 424 425 426 206 429 400 428 400 430 208 418 426 6 FIG. The systemcan further include one or more patient sites(for instance, medical centers or hospitals) each having one or more computing devices(such as, one or more nurse PCs), one or more medical procedure robots(which can be, for instance, same as or similar to the robotic surgery system, and can be referred to as robot), one or more imaging systems(such as, a video endoscope) that can be part of the robotic surgery system, one or more patient-side connectivity clients, one or more patient-side adapters(which can be same as or similar to the patient-side interface), and a patient-side gateway. The systemcan also include one or more telemedicine devicesconfigured to communicate telemedicine information and provide the physician with audio and video related to any procedures the physician is performing. The systemcan further include a network(which can utilize the networkas is further explained in connection with) connecting a physician-side adapterto a patient-side adapter.

418 416 426 422 412 420 422 In some cases, as described herein, a physician-side adaptercan be integrated with a robot control and display systemand/or a patient-side adaptercan be integrated with a robot. In some instances, a physician PCcan be integrated with a robot control and display system and/or a nurse PCcan be integrated with a robot. Being integrated with can encompass being wholly separate from a corresponding system or being wholly or partially a portion of the corresponding system. For instance, being integrated with can encompass being implemented as software and/or firmware being executed by one or more processors of the corresponding system.

400 406 432 434 435 436 438 400 408 400 410 428 The systemcan include one or more computing devices, which can form a computing cloud. The cloud can implement one or more of: an orchestration server or application, a connectivity server, a network management system(NMS) (sometimes referred to as network control system or NCS), an adapter management server or system(sometimes referred to as SAMS), and a data and analytics server or platform. The systemcan further include a health system information systems, comprising a database storing electronic health records (EHR) and/or electronic medical records (EMR) relating to one or more patients. The systemcan further include one or more medical-grade audio/visual (A/V) systems, which can communicate with one or more telemedicine devices.

432 434 418 426 436 As described herein, the orchestration applicationcan perform one or more of: verify credentials of a physician, provide coordination between the patient side and physician side (or verify that such coordination has been established), establish an A/V connection between the physician side and the patient side (or verify that the A/V connection has been established), verify that a time window for remotely performing a medical procedure on the patient is open, and verify that network connection satisfies one or more conditions. As described herein, the connectivity servercan track network addresses of the physician-side adaptersand the patient-side adaptersand establish a connection between a physician-side adapter and a patient-side adapter. As described herein, the adapter management systemcan perform adapter monitoring and management. For example, the health of the adapters can be verified and tracked.

412 410 432 412 412 414 404 414 410 404 402 412 432 412 432 412 416 416 412 412 416 418 A physician PCcan be operably connected to a medical-grade A/V systemand the orchestration application. In an example, the physician PCcan communicate telemedicine information and provide the physician with audio and video related to any robotic procedures the physician is conducting. For example, the physician PCcan display to the physician on a monitora real-time video of a patient site, the premises where a medical procedure will take place, is being performed, or has been performed. The monitorcan display such footage in response to the medical-grade A/V systemproviding video footage of the patient siteto the physician site. The physician PCcan also be operably connected to the orchestration application. The physician PCcan transmit physician related information to the orchestration application. The physician related information can include information such as the physician's credentials, identification, schedule, specialties, and any access related information related to the robotic procedures the physician will perform. In some implementations, a single physician PCcan be used for multiple physician input consoles. In some cases, each physician input consolecan have a dedicated physician PC(for instance, such dedicated physician PCcan be connected to the physician input consoleor its associated physician-side adaptervia a wired or wireless connection).

415 418 430 406 415 418 415 418 435 436 434 415 418 418 416 415 416 A physician-side connectivity clientcan allow a physician-side adapterto connect to the networkand cloud. The physician-side connectivity clientcan be implemented in software and/or firmware being executed by one or more processors of the physician-side adapter. The physician-side connectivity clientcan call one or more application programming interfaces (APIs) to connect the physician-side adapterto one or more of the network management system, the adapter management system, or the connectivity server. In some instances, the physician-side connectivity clientmay be implemented by a computing device that is separate from the physician-side adapter. In implementations that integrate the physician-side adapterwith the physician input console, the physician-side connectivity clientcan be implemented by the physician input console.

415 418 402 430 415 406 430 425 425 418 415 425 A physician-side connectivity client(or a physician-side adapter) can be assigned an internal internet protocol (IP) address and an external IP address. The internal IP address can correspond to an IP address with respect to a local network of a physician site. The external IP address can correspond to an IP address outside of that local network (such as, IP address on the network). The physician-side connectivity clientcan communicate with the cloudvia the networkand provide information (such as, the internal IP address and the external IP address) to initiate a connection with a patient-side connectivity client. The information to initiate a connection with the patient-side connectivity clientcan include one or more of: an identifier of the physician-side adapter, an internal IP address of the physician-side connectivity client, or any or information needed to establish a connection with the patient-side connectivity client.

416 416 418 416 424 414 404 414 416 422 A physician input consolecan include a visual display to show the physician visual indications relating to the robotic procedure. The physician input consolecan be operably coupled to a physician-side adapter. The physician input consolecan display a view of the robotic procedure site (for instance, as detected by an imaging system) and/or any other component relevant to the robotic procedure. A monitorcan display visual indicators representing a strength of signal connectivity to the components in the patient site. In another example, the monitorcan display device characteristics regarding the physician input consoleand/or the robot.

114 416 416 418 416 416 416 416 416 As described in connection with a physician input console, a physician input consolecan include one or more devices used to control one or more medical procedure robots. The physician input consolecan be operably coupled to a physician-side adapter. In an example, robot controls of the physician input consolecan control movement, actuation, clutch, or any other relevant feature for a medical procedure robot to perform robotic procedures. The physician input console, and the corresponding console, can include a type. The type can correspond to the manufacturer of the physician input console, model of the physician input console, and/or version of the software or firmware being executed by one or more processors or the physician input console. For example, the manufacturer of the physician input consolecan include Intuitive Surgical, Medtronic, or any other manufacturer of a physician input console. As another example, the model of the physician input consolecan include Da Vinci Xi, Da Vinci X, or Da Vinci SP manufactured by Intuitive Surgical.

418 418 416 418 426 430 406 434 436 418 416 416 406 430 418 416 418 415 402 A physician-side adaptercan include a physical device, program, application, application programming interface (API), software development kit (SDK), or another device or program to allow remote robotic procedure. In some implementations, the physician-side adaptercan be software and/or firmware being executed by one or more processors of a physician input console. The physician-side adaptercan be operably coupled to a patient-side adaptervia the networkand/or the cloud, including the connectivity serverand the adapter management system. In an example, the physician-side adaptercan include a device operably coupled to the physician input console, to interface the physician input consoleto the cloudand the network. In this example, the physician-side adaptercan include hardware components and software components to receive communication signals from the physician input console. In this example, the physician-side adapter(or a physician-side connectivity client) can include an internal internet protocol (IP) address. The internal IP address can correspond to an IP address with respect to a local network of a physician site.

418 426 430 400 410 412 420 428 A physician-site adapterand/or a patient-side adaptercan be configured software-defined wide-area network (SD-WAN) devices. The networkcan be configured as SD-WAN network connecting such SD-WAN devices. Internal IP addresses can be used to communicate with devices on the SD-WAN. The internal IP address can be used to establish the connection for remote robotic procedure since the adapters would be part of the same WAN, and external IP addresses may not need to be used. Any other components of the system, such as an A/V system, physician PC, nurse PC, or telemedicine device, can be similarly configured as SD-WAN devices and become part of the SD-WAN.

419 415 402 430 415 419 402 419 415 430 Physician-side gatewaycan forward network traffic between one or more physician-side connectivity clientsat a physician siteand the network. A physician-side connectivity clientcan be connected to the physician-side gatewayvia a suitable network connection available at the physician site, such as LAN (for instance, implemented using Ethernet or Wi-Fi). In some instances, the physician-side gatewaymay not be present, and the physician-side connectivity clientcan be directly connected to the network.

416 402 418 415 419 419 419 When multiple physician input consolesare present at the physician site, each can be connected directly or through one or more of its dedicated physician-side adapteror physician-side connectivity clientto the physician-side gatewayvia a dedicated network connection (such as, via a dedicated Ethernet cable plugged into a port in the physician-side gateway). This dedicated network connection can be a LAN. In this arrangement, no physician input console shares, at a physician site, any network connection (such as, LAN) with any other physician input console and each physician input console has its own dedicated network connection to a physician-side gateway. The physician-side gatewaycan be a single gateway with sufficient number of ports to connect all physician input consoles or a collection of gateways.

420 432 420 432 420 422 422 420 420 422 426 A nurse PCcan also be operably connected to the orchestration application. The nurse PCcan transmit patient related information to the orchestration application. The patient related information can include the patient's health records, identification, schedule, notes, and any access related information related to the robotic procedures the patient can receive. In some implementations, a single nurse PCcan be used for robots. In some cases, each robotcan have a dedicated nurse PC(for instance, such dedicated nurse PCcan be connected to the robotor its associated patient-side adaptervia a wired or wireless connection).

422 422 426 422 422 422 422 422 A robotcan include one or more robotic devices used to perform robotic procedures. The robotcan be operably coupled to a patient-side adapter. In an example, the robotcan receive controls to perform movement, actuation, power, and any other relevant feature to perform a robotic procedure. The robot, and any corresponding devices, can include a type. The type can correspond to the manufacturer of the robot, model of the robot, and/or version of the software or firmware being executed by one or more processors of the robot. For example, the manufacturer of the robotcan include Intuitive Surgical, Medtronic, or any other manufacturer of medical procedure robots. As another example, the model of the robotcan include Da Vinci Xi, Da Vinci X, or Da Vinci SP manufactured by Intuitive Surgical.

424 424 426 422 424 402 An imaging systemcan communicate video to the physician related to any robotic procedures the physician is performing. The imaging systemcan be operably coupled to the patient-side adapter(directly or through the robot). In an example, the imaging systemcan provide to the physician sitea view of a robotic procedure site. The view can include a real-time perspective of the patient before, during, or after robotic procedure is performed.

425 426 430 406 425 426 425 426 435 436 434 425 426 426 422 425 422 A patient-side connectivity clientcan allow a patient-side adapterto connect to the networkand cloud. The patient-side connectivity clientcan be implemented in software and/or firmware being executed by one or more processors of the patient-side adapter. The patient-side connectivity clientcan call one or more APIs to connect the patient-side adapterto one or more of the network management system, the adapter management system, or the connectivity server. In some instances, the patient-side connectivity clientmay be implemented by a computing device that is separate from the patient-side adapter. In implementations that integrate the patient-side adapterwith the robot, the patient-side connectivity clientcan be implemented by the robot.

425 426 404 430 415 426 425 415 A patient-side connectivity client(or a patient-side adapter) can include an internal IP address and an external IP address. The internal IP address can correspond to an IP address with respect to a local network of a patient site. The external IP address can correspond to an IP address outside of that local network (such as, IP address on the network). The information to initiate a connection with the physician-side connectivity clientcan include one or more of: an identifier of the patient-side adapter, an internal IP address of the patient-side connectivity client, or any other information needed to establish a connection with the physician-side connectivity client.

426 418 430 406 426 426 422 422 406 430 426 422 430 406 426 422 418 426 418 426 426 418 426 426 A patient-side adaptercan be operably coupled to a physician-side adaptervia the networkand/or the cloud. The patient-side adaptercan include one or more of a physical hardware, program, application, API, SDK, or another device or program to allow remote robotic procedures. For example, patient-side adaptercan include a device operably coupled to a robotto interface the robotto the cloudand the network. In this example, the patient-side adaptercan include hardware components and software components to receive communication signals from the robotand establish a network connection to the networkand the cloud. In some implementations, the patient-side adaptercan be software and/or firmware being executed by one or more processors of the robot. Similarly to a physician-side adapter, the patient-side adaptercan include an internal IP address and an external IP address. As described herein, one or more of such IP addresses can be utilized to establish a connection with the physician-side adapter. The information to initiate a connection with the physician-side adaptercan include an identifier of the patient-side adapter, an internal IP address of the patient-side adapter, an external IP address of the physician-side adapter, and/or any or information relevant to establish a connection with the patient-side adapter. As described herein, the patient-side adaptercan be configured as SD-WAN device and its internal IP address can be used to establish the connection.

428 428 410 428 402 404 428 412 410 428 428 410 428 404 402 404 402 404 402 404 402 A telemedicine devicecan communicate telemedicine information and provide a physician with audio and video related to any robotic procedures the physician is performing. The telemedicine devicecan be operably coupled to a medical-grade A/V system. In an example, the telemedicine devicecan provide to the physician sitea view of the patient site(such as, an operating room). The view can include a real-time perspective of the patient before, during, or after a procedure is performed. In another example, the telemedicine devicecan receive information from a physician PCthrough the medical-grade A/V system. For example, the telemedicine devicecan receive information related to the procedure, including one or more of a notice regarding the physician's readiness, status of connectivity, updated patient health records, or scheduling information. In this example, the related information can include the physician's credentials, identification, schedule, specialties, and any access related information related to the robotic procedures the physician will perform. In another example, the telemedicine devicecan further include an A/V system including a third-party telemedicine hardware provider and medical cart. The A/V systemand/or the telemedicine devicecan facilitate provision of an audio and/or video feed from the patient siteto a physician site(and vice versa) as well as facilitate a two-way audio and/or video communication between the patient siteand the physician site. In some instances, a two-way audio communication between the patient siteand the physician siteand a one-way video communication from the patient siteto the physician sitecan be utilized.

429 425 404 430 425 429 404 429 425 430 Patient-side gatewaycan forward network between one or more patient-side connectivity clientsat a patient siteand the network. A patient-side connectivity clientcan be connected to the patient-side gatewayvia a suitable network connection available at the patient site, such as LAN. In some instances, the patient-side gatewaymay not be present, and the patient-side connectivity clientcan be directly connected to the network.

422 404 426 425 429 429 429 When multiple robotsare present at the patient site, each can be connected directly or through one or more of its dedicated patient-side adapteror patient-side connectivity clientto the patient-side gatewayvia a dedicated network connection (such as, via a dedicated Ethernet cable plugged into a port in the patient-side gateway). This dedicated network connection can be a LAN. In this arrangement, no robot shares, at a patient site, any network connection (such as, LAN) with any other robot and each robot has its own dedicated network connection to a patient-side gateway. The patient-side gatewaycan be a single gateway with sufficient number of ports to connect all robots or a collection of gateways.

430 418 426 430 418 426 430 418 426 418 426 424 The networkcan connect the physician-side adapterand the patient-side adapter. The networkcan be configured as SD-WAN to provide connectivity between the physician-side adapterand the patient-side adapter. The networkcan facilitate a peer-to-peer connection between a physician-side adapterand a patient-side adapter. Such peer-to-peer connection can allow the physician-side adapterand the patient-side adapterto transmit and receive information and instructions (such as, in the form of data packets) directly. The information can include robot control instructions and feedback sensor information, real-time patient information including medical health monitoring statuses, patient-side video endoscope content (for example, from the imaging system), network connectivity strength including a primary and alternate network connectivity options (for example, SD-WAN, 5G, Ethernet, fiber optic, satellite communication, or any other type of connection available), and any other information relevant to the peer-to-peer network connection.

430 418 426 434 418 434 426 434 418 426 There can be several ways for establishing a connection via the network. For example, a physician-side adaptercan request connection to a patient-side adapterfrom the connectivity server. For example, the physician-side adaptercan transmit a request to the connectivity serverand receive the patient-side adapterinternal IP address from the connectivity server. In this example, the physician-side adaptercan then request to establish a connection (such as, a direct peer-to-peer connection) with the patient-side adapter.

418 426 436 418 434 426 436 418 426 418 426 426 As another example, a physician-side adaptercan request a connection to a patient-side adapterfrom the adapter management system. For example, the physician-side adaptercan transmit a request to the connectivity serverand receive the patient-side adapterinternal IP address from the adapter management system. In this example, the physician-side adaptercan then request to establish a connection (such as, a direct peer-to-peer connection) with the patient-side adapter. While these examples describe that the physician-side adapterinitiates the connection to the patient-side adapter, the patient-side adaptercan similarly initiate the connection in some implementations.

In any of these examples, external IP address(es) can also be used to establish the connection. As described herein, external IP address(es) can be used when the adapters are not part of the same network (such as, not part of the same SD-WAN).

432 The connection can be established in response to: 1) verification of login credentials of a physician, 2) completion of coordination between the physician side and patient side (such as, completion of one or more handshake protocols), 3) establishment of a two-way audio communication between the physician side and the patient side, 4) establishment of a video communication from at least the patient side to the physician side, 5) verification of compatibility of physician input console and robot, and 6) verification that the network connection satisfies one or more network conditions (such as, one or more of a network latency threshold, network jitter threshold, network packet loss threshold, and network bandwidth threshold). In some instances, the connection can be established in response to ensuring that at least one of the foregoing conditions, at least two of the forgoing conditions, at least three of the foregoing conditions, at least four of the foregoing conditions, or all of the foregoing conditions have been satisfied. In some cases, the orchestration applicationcan perform the verifications.

432 412 420 432 418 426 418 426 434 418 434 418 418 434 426 426 426 A connection establishment protocol can be implemented to form the connection. The connection establishment protocol can be coordinated by the orchestration application, for instance, responsive to a request to start a session received from a patient side or physician side. The request can be received through a user interface provided by a physician PCor nurse PC. Responsive to the request, conditions for establishing the connection can be verified (as described herein). After it has been verified that the connection can be established, the orchestration applicationcan transmit a request to initiate the connection. The request to initiate the connection can include identifiers of a physician-side adapterand patient-side adapter(for instance, IP addresses of the physician-side adapterand patient-side adapter, as described herein). The request to initiate the connection can be transmitted to the connectivity server, which can forward a request to begin connection to the physician-side adapter. The connectivity servercan forward the request to begin connection to the IP address of the physician-side adapter. In response to receiving the request to begin connection, the physician-side adaptercan generate an offer to connect. The offer can be transmitted to the connectivity server, which can forward the offer to the patient-side adapter(for instance, to the IP address of the patient-side adapter). The connection can be established responsive to the patient-side adapterreceiving the offer.

430 418 426 434 In some implementations, the networkcan facilitate server-based connectivity (rather than peer-to-peer connectivity). For example, both adaptersandcan transmit data packets through the connectivity serverto communicate with each other.

400 422 416 400 422 416 422 416 422 416 400 430 422 416 422 418 426 422 416 400 430 In some examples, the systemcan assess whether a type of a robotis compatible with a physician input console. In this example, the systemwill compare the types of the robotand the physician input consoleto ensure the types are compatible (such as, the same) prior to providing information to establish a connection between the robotand the physician input console. In this example, when the robotis of a first type and the physician input consoleare of the first type, the systemwill provide over the networkinformation to one or both of the robotand the physician input consoleto allow the devices to establish a connection (such as, a peer-to-peer connection) for remotely controlling the robot. Such connection can be established between the physician-side adapterand the patient-side adapter. In another example, when the robotis of a first type and the physician input consoleare of a second type that is different from the first type, the systemwill restrict provision of the information over the networkand prevent the devices from establishing the connection.

430 418 426 422 418 426 422 422 422 418 426 It should be noted that a preliminary maintenance connection may be formed via the networkbetween a physician-side adapterand a patient-side adapterprior to forming the operational connection for remotely controlling the robot. The preliminary maintenance connection can be used by the physician-side adapterand the patient-side adapterfor exchanging information related to discovery, status, keeping the preliminary connection alive, or the like. This type of connection can be distinct from an operational connection (where the operational connection may be otherwise known as a “session”) for remotely controlling the robotduring which the following types of data would be transmitted: control signals (or control commands) transmitted from the physician side to the patient side for moving and/or controlling one or more instruments or imaging systems of a robot, status information transmitted from the patient side to the physician side or from the physician side to the patient side (such as, heartbeat signal or other data for ensuring safety), and image data of the procedure site transmitted from the patient side to the physician side. When the operational connection for remotely controlling the robotis established between a physician-side adapterand a patient-side adapter, all these three types of data would be exchanged between the physician side and patient side.

400 Status information can include transmission of signals from the patient side to the physician side and from the physician side to the patient side for monitoring the status of the system. For example, the patient side can transmit to the physician side status information indicating that it is operating normally (for instance, this can be a heartbeat signal). As another example, the physician side can transmit to the patient side status information that it is operating normally.

422 416 422 422 400 414 420 430 412 412 In some instances, a connection for remotely controlling a robotwould not be established (and the three types of data described herein would not be exchanged) unless there has been coordination between the patient side and physician side. Coordination can include one or more of performing safety checks (such as, compatibility between the types of the physician input consoleand the robot), ensuring that the patient site (such as, the operating room) and robothave been prepared for a medical procedure, ensuring that the patient has been prepared for the procedure, or the like. In some cases, coordination can be performed by the systemand may include completion of or more checklists on the patient side (for instance, by a circulating nurse) and attestation by the physician that the one or more checklists have been completed correctly (such as, by clicking “Attest” on a user interface displayed on the monitor). A checklist can be completed on a nurse PC, transmitted to the physician side via the network, displayed on a physician PC, and attested to by the physician through the physician PC.

422 In some instances, at least some types of data related to the connection may be transmitted prior to establishing a connection for remotely controlling a robot. For example, image data of the procedure site may be transmitted to help the physician prepare for a procedure (such as, plan the procedure). Transmission of control signals and status information may be commenced at the same time.

422 422 416 422 422 416 422 422 412 414 414 420 A session for remotely controlling the robotcan be associated with a time window during which a physician is allowed to remotely control the robotto perform a medical procedure on a patient, subsequent to a completion of coordination (such as, signoffs) as described herein. The time window can correspond to the scheduled time of the medical procedure (such as, to an allotted session time slot). After such time window has opened and over duration of the time window, the operational connection from the physician input consoleto remotely control the robotmay be allowed, subsequent to the completion of coordination, while an operational connection from any other physician input console to remotely control the robotmay be disallowed. After the time window has ended, an operational connection from the physician input consoleto remotely control the robotmay be disallowed as it is possible that another time window has been opened to permit the same or another physician input console to connect to the robotto remotely control the robot to perform a medical procedure on a different patient. That is, time windows for remotely controlling a particular robot can be arranged in non-overlapping chronological order. The operational connection may be initiated responsive to completion of the coordination between the patient side and physician side, which, as described herein, can involve completion of one or more checklists and attestation of the one or more checklists (this can be referred to as signoffs). The physician can be informed that the time window has been opened, for instance, via the surgeon PCand the monitor(such as, via a status being shown on a schedule). In response to the notification, the physician can initiate the operational connection to remotely control the robot (for instance, by clicking “Attest” on the user interface displayed on the monitor). On the patient side, the clinical staff can be informed that the time windows have been opened, for instance, via the nurse PC.

432 432 406 408 410 412 420 434 436 438 435 432 422 416 The orchestration applicationcan include an orchestration and collaboration platform for physicians, patients, clinical staff, and administrative personnel to manage remote robotic procedure programs. The orchestration applicationcan be executed on one or more remote servers in the cloudand can be operably connected to the health system information system, one or more A/V systems, one or more physician PCs, one or more nurse PCs, connectivity server, the adapter management system, the data and analytics platform, and the network management system. In some examples, the orchestration applicationis configured to assess whether a type of a robotis compatible with a physician input console.

400 432 422 418 426 The assessment of compatibility can occur prior to or at a time of a procedure. For example, the system(such as, via the orchestration application) can assess the compatibility at the time the procedure is scheduled, which can be well before the time of procedure (such as, hours, days, or weeks) and well before the connection for remotely controlling the robotis established between the adaptersand. As a safety check, compatibility may be verified again prior to forming the connection.

400 In another example, the systemcan assess compatibility at the time of procedure (such as, close to the initiation of the connection). This can be performed minutes or even seconds prior to the procedure.

432 422 416 432 422 The process for the orchestration applicationto assess the compatibility between a robotand the physician input consolecan be an automated process, where there is no user intervention to begin the assessment of the compatibility. For example, the orchestration applicationcan pre-verify compatibility of the types prior to when the connection for remotely controlling the robotis established.

400 432 422 416 422 422 416 432 430 426 418 422 416 432 430 The system(such as, via the orchestration application) can compare the types of a robotand a physician input consoleto ensure the types are compatible prior to establishment of the connection for remotely controlling the robot. For example, when the robotis of a first type and the physician input consoleare of the first type, the orchestration applicationcan provide over the networkinformation to one or both of the patient-side adapterand physician-side adapterto allow the devices to establish a connection (such as, a peer-to-peer connection). In another example, when the robotis of a first type and the physician input consoleare of a second type that is different from the first type, the orchestration applicationwill restrict provision of the information over the networkand prevent the devices from establishing the connection.

434 434 418 426 432 438 434 418 426 The connectivity servercan include a network signaling server. The connectivity servercan be operably coupled to one or more physician-side adapters, one or more patient-side adapters, the orchestration application, and the data and analytics platform. The connectivity servercan provide a service of connecting the physician-side adapterand the patient-side adapter.

434 418 426 434 418 426 434 418 418 436 434 426 418 426 434 426 426 418 430 426 434 426 418 418 430 434 426 434 418 426 434 418 For example, the connectivity servercan receive a request from a physician-side adapterto establish a connection with a patient-side adapter(or vice versa). In this example, the connectivity servercan obtain the physician-side adapterinformation, including an identifier, an external IP address (if needed), an internal IP address and patient-side adapterinformation, including an identifier, an external IP address (if needed), and an internal IP address. The connectivity servercan obtain the physician-side adapterinformation from the physician-side adapterand/or from the adapter management system. In this example, the connectivity servercan also receive an identifier of the patient-side adapterfrom the physician-side adapter, indicating the patient-side adapterwith which to establish a connection. The connectivity servercan then transmit a request to the patient-side adapter, to determine whether the patient-side adapteris capable of establishing a connection to the physician-side adapterover the network. In response to receiving an approval from the patient-side adapter, the connectivity servercan transmit the patient-side adapterinformation to the physician-side adapterto allow the physician-side adapterto establish a connection between the adapters (for example, via the network). In this example, the connectivity servercan transmit the patient-side adapteridentifier, internal IP address, and external IP address (if needed). The connectivity servercan provide a threshold security procedure to assess whether the physician-side adapterhas authorization to establish a connection with the patient-side adapter. In this example, the connectivity servercan include an access control list of authorized adapters and compare the identifier of the physician-side adapterto verify authorization.

434 426 418 434 426 426 434 426 426 436 434 418 426 418 434 418 418 426 430 418 434 418 426 426 430 434 418 434 426 418 434 426 In another example, the connectivity servercan receive a request from a patient-side adapterto establish a connection with a physician-side adapter. The connectivity servercan also obtain the patient-side adapterinformation, including an identifier, an external IP address (if needed), an internal IP address and patient-side adapterinformation, including an identifier, an external IP address (if needed), and an internal IP address. The connectivity servercan obtain the patient-side adapterinformation from the patient-side adapterand/or from the adapter management system. The connectivity servercan also receive an identifier of the physician-side adapterfrom the patient-side adapter, indicating the physician-side adapterwith which to establish a connection. The connectivity servercan then transmit a request to the physician-side adapter, to determine whether the physician-side adapteris capable of establishing a connection to the patient-side adapterover the network. In response to receiving an approval from the physician-side adapter, the connectivity servercan then transmit the physician-side adapterinformation to the patient-side adapterto allow the patient-side adapterto establish a connection between the adapters (for example, via the network). In this example, the connectivity servercan transmit the physician-side adapteridentifier, internal IP address, and external IP address (if needed). The connectivity servercan provide a threshold security procedure to assess whether the patient-side adapterhas authorization to establish a connection with the physician-side adapter. In this example, the connectivity servercan include an access control list of authorized adapters and compare the identifier of the patient-side adapterto verify the authorization.

434 432 418 426 434 418 426 434 436 434 426 432 426 418 434 418 418 426 430 418 434 418 426 418 430 434 418 426 418 434 430 434 In another example, the connectivity servercan receive a request from the orchestration applicationto establish a connection between a physician-side adapterand a patient-side adapter. The connectivity servercan obtain the physician-side adapterinformation, including an identifier, an external IP address (if needed), an internal IP address and patient-side adapterinformation, including an identifier, an external IP address (if needed), and an internal IP address. The connectivity servercan obtain the information from the adapters and/or from the adapter management system. For instance, the connectivity servercan receive the patient-side adapteridentifier from the orchestration applicationto establish a connection between the patient-side adapterand the physician-side adapter. The connectivity servercan then transmit a request to the physician-side adapterto determine whether the physician-side adapteris capable of establishing a connection to the patient-side adapterover the network. In response to receiving approval from the physician-side adapter, the connectivity servercan then transmit the physician-side adapterinformation to the patient-side adapterto allow the physician-side adapterto establish a connection between the adapters (for example, via the network). In this example, the connectivity servercan transmit the physician-side adapteridentifier, internal IP address, and external IP address (if needed) for the patient-side adapterto establish a connection with the physician-side adapter. The connectivity servercan provide a threshold security procedure to assess whether the adapters have authorization to establish a connection across the network. The connectivity servercan include an access control list of authorized adapters and compare the identifiers of the adapters to verify authorization.

436 436 418 426 432 438 436 406 406 436 436 The adapter management systemcan provide adapter monitoring and management. The adapter management systemcan be operably coupled to one or more physician-side adapters, one or more patient-side adapters, the orchestration application, and the data and analytics platform. In an example, the adapter management systemcan store information regarding adapters connected to the cloud. The information stored can include identifiers, internal IP addresses, and external IP addresses (if needed) of the adapters. In this example, the adapters connected to the cloudare in a trusted state (for instance, part of the same SD-WAN), such that the adapter management systemcommunicates directly with the adapters. In this example, the adapter management systemcan communicate with the adapters as if the adapters are on the same local network, such that there is no need to communicate using an external IP address, as described herein.

438 438 432 434 435 436 438 400 The data and analytics platformcan include a data repository for analysis and reports, which can improve the performance of the medical procedure teams and technology that facilitates remote robotic-assisted procedures. The data and analytics platformcan be operably coupled to the orchestration application, the connectivity server, the network management systemand the adapter management system. The data and analytics platformcan store data from remote robotic procedures performed using the system.

400 408 410 412 414 416 418 420 422 424 426 406 432 434 435 436 415 425 419 429 438 430 406 430 406 430 406 400 400 430 406 408 406 The aforementioned components of the system(such as, one or more of the health system information systems, a medical-grade A/V system, a physician PC, a monitor, a physician input console, a physician-side adapter, a nurse PC, a robot, an imaging system, a patient-side adapter, the cloud, the orchestration application, the connectivity server, the network management system, the adapter management system, connectivity clientsor, gatewaysor, or the data and analytics platform) can be communicably coupled to each other via the networkand/or the cloud, such that data can be transmitted between the components. The networkand the cloudcan include the Internet, intranet, or other suitable network. The data transmission can be encrypted, unencrypted, over a virtual private network (VPN) tunnel, or other suitable communication means. The networkand the cloudcan be a wide area network (WAN) (such as, SD-WAN), local area network (LAN), personal area network (PAN), or another suitable network type. The network communication between any of the systemcomponents can be encrypted using pretty good privacy (PGP), Blowfish, Twofish, triple data encryption standard (3DES), hypertext transfer protocol secure (HTTPS), or other suitable encryption. The systemcan be configured to provide communication via the various systems, components, and modules disclosed herein via an application programming interface (API), peripheral component interface (PCI), PCI-Express, American National Standards Institute (ANSI)-X12, Ethernet, Wi-Fi, Bluetooth, or other suitable communication protocol or medium. Additionally, third party systems and databases can be operably coupled to the system components via the networkand/or the cloud. For example, an EHR/EMR system (such as, the system) can be operably coupled to the cloudto transmit patient information, scheduling information relating to a procedure, physician information, or any other relevant information to perform remote robotic procedure.

400 The data transmitted to and from the components of system, can include any format, including JavaScript Object Notation (JSON), transfer control protocol (TCP)/IP, extensible markup language (XML), hypertext markup language (HTML), American Standard Code for Information Interchange (ASCII), short message service (SMS), comma-separated value (CSV), representational state transfer (REST), or other suitable format. The data transmission can include a message, flag, header, header properties, metadata, and/or a body, or be encapsulated and packetized by any suitable format having same.

430 406 432 434 435 436 438 430 406 432 434 435 436 438 430 406 432 434 435 436 438 430 406 430 406 432 434 435 436 438 430 430 406 The networkand/or the cloud, including the orchestration application, connectivity server, network management system, adapter management system, and data and analytics platform, can be implemented in hardware, software, or a suitable combination of hardware and software therefor, and may comprise one or more software systems operating on one or more servers having one or more processors with access to memory. The networkand/or the cloud, including the orchestration application, connectivity server, network management systemadapter management system, and data and analytics platform, can include electronic storage, one or more processors, and/or other components. The networkand/or the cloud, including the orchestration application, connectivity server, network management systemadapter management system, and data and analytics platform, can include communication lines, connections, and/or ports to enable the exchange of information via a networkand/or the cloud, and/or other computing platforms. The networkand/or the cloud, including the orchestration application, connectivity server, network management systemadapter management system, and data and analytics platform, can also include a plurality of hardware, software, and/or firmware components operating together to provide the functionality attributed herein. For example, the networkcan be implemented by a cloud of computing platforms operating together as the network, including Software-as-a-Service (SaaS) and Platform-as-a-Service (PaaS) functionality. Additionally, the cloudcan be implemented using commercial cloud computing platforms, including all such functionality provided by the commercial cloud computing platform.

400 430 406 430 406 430 406 Any of the components of the systemcan comprise electronic storage that stores information. The electronic storage can include one or both of system storage that can be provided integrally (such as, substantially non-removable) with the networkand/or the cloud, and/or removable storage that can be removably connectable to the networkand/or the cloudvia, for example, a port (such as, a Universal Serial Bus (USB) port, a firewire port, etc.) or a drive (such as, a disk drive, etc.). Electronic storage may include one or more of optically readable storage media (such as, optical disks, etc.), magnetically readable storage media (such as, magnetic tape, magnetic hard drive, floppy drive, etc.), electrical charge-based storage media (such as, erasable electronic programmable read only memory (EEPROM), random access memory (RAM), etc.), solid-state storage media (such as, flash drive, etc.), and/or other electronically readable storage media. Electronic storage may include one or more virtual storage resources (such as, cloud storage, a virtual private network, and/or other virtual storage resources). The electronic storage can include a database, or public or private distributed ledger (such as, blockchain). Electronic storage can store machine-readable instructions, software algorithms, control logic, data generated by processor(s), data received from server(s), data received from computing platform(s), and/or other data that can enable server(s) to function as described herein. The electronic storage can also include third-party databases accessible via the networkand/or the cloud.

400 430 406 430 406 Any of the components of the systemcan include control circuitry, such as processor(s) or controller(s), configured to provide data processing capabilities, for instance, in the networkand/or the cloud. As such, any of the processors can include one or more of a digital processor, an analog processor, a digital circuit designed to process information, an analog circuit designed to process information, a state machine, and/or other mechanisms for electronically processing information, such as field programmable gate arrays (FPGAs) or application specific integrated circuits (ASICs). The processor(s) can be a single entity or include a plurality of processing units. These processing units can be physically located within the same device, or processor(s) can represent processing functionality of a plurality of devices or software functionality operating alone, or in concert. A networked computer processor can be a processor operably coupled to the networkand/or the cloud. The networked computer processor can be operably coupled to other processors, databases, or components.

432 434 435 436 438 400 The orchestration application, connectivity server, network management systemadapter management system, and data and analytics platformcan be configured with machine-readable instructions having one or more functional modules. The machine-readable instructions can be implemented on one or more servers, having one or more processors, with access to memory. The machine-readable instructions can be a single networked node, or a machine cluster, which can include a distributed architecture of a plurality of networked nodes. The machine-readable instructions can include control logic for implementing various functionality, as described in more detail below. The machine-readable instructions can include certain functionality associated with the system. Additionally, the machine-readable instructions can include a smart contract or multi-signature contract that can process, read, and write data to the database, distributed ledger, or blockchain.

5 FIG. 500 400 500 418 512 426 514 512 416 514 422 512 514 415 512 425 514 illustrates a schematic view of a remote robotic-assisted medical system, which can be similar to the system. As is described herein, in system, the functionality of a physician-side adaptercan be implemented in software and/or firmware by an interface, and the functionality of a patient-side adaptercan be implemented in software and/or firmware by an interface. The interfacecan be executed by one or more processors of the physician console, and the interfacecan be executed by one or more processors of the robot. In some instances, the interfacesandcan be SDKs. The functionality of a physician-side connectivity clientcan be similarly implemented by the interface, and the functionality of a patient-side connectivity clientcan be similarly implemented by the interface.

416 502 512 432 434 435 436 520 422 530 540 502 419 512 432 434 435 436 A physician consolecan include a bridge(which can be implemented in software and/or firmware) that connects the interfacewith one or more of the orchestration application, connectivity server, network management system, or adapter management system. As described herein, the physician console can receive image datafrom the robot, provide control signalsto the robot, and exchange status informationwith the robot. In some instances, the bridgecan function as or similarly to the gateway, which can forward traffic between the interfaceand one or more of the orchestration application, connectivity server, network management systemor adapter management system.

422 504 514 432 434 435 436 522 416 532 542 504 429 514 432 434 435 436 A robotcan include a bridge(which can be implemented in software and/or firmware) that connects the interfacewith one or more of the orchestration application, connectivity server, network management systemor adapter management system. As described herein, the robot can provide image datato the physician console, receive control signalsfrom the physician console, and exchange status informationwith the physician console. In some instances, the bridgecan function as or similarly to the gateway, which can forward traffic between the interfaceand one or more of the orchestration application, connectivity server, network management systemor adapter management system.

Network for Remotely Controlling Robotic Procedures

430 Interconnecting physician input consoles and robotic systems can involve considerable expense and effort. For instance, suppose that a patient site (such as, a hospital or another suitable site) that houses one or more robots desires to allow such one or more robots to be controlled by one or more remotely located physician input consoles. To reduce transmission delay and guarantee reliability and stability of transmission, a high-quality network connection is required rather than using the public Internet, and therefore the hospital would need to design and deploy a suitable network (such as, the network) that provides one or more connections between the one or more robots and consoles. A physician site (such as, a medical center, physician center, or another suitable site) housing one or more physician input consoles may need to undergo a similar process. Undesirably, such undertaking can be difficult, time consuming, and expensive. Further, each hospital and physician center that wishes to provide remotely controlled robotic procedures may need to design and deploy its own network, which can lead to wasteful duplication of effort and resources.

To address these shortcomings, a network for remotely controlling robotic procedures can be designed and deployed. Such network can include one or more nodes for connecting patient sites and physician sites. A node can be referred to as a point-of-presence (POP) node (which can also be referred to as a data center). To connect to the network, patient sites and physician sites may only need to employ a suitable last mile or last kilometer connection (sometimes referred to as an onramp connection or onramp) that satisfies network requirements for remote robotic procedures (which are described herein). Last mile connection can connect a patient-side gateway or physician-side gateway to a PoP. For example, a patient site or physician site may utilize a dedicated connection (such as, a leased line) for connecting with a PoP. In some cases, an onramp connection can be a direct connection. A direct connection may not pass through any routers or switches to connect a gateway to a PoP. A direct connection can provide high performance (such as, high bandwidth, low latency, low packet loss, and low jitter). In some cases, an onramp connection can be a fiberoptic connection. The network can be a single network covering a particular geographical area or region (for instance, the continental United States or other regions). Advantageously, this approach can simplify and streamline deployment of remotely-controlled robotic systems.

6 FIG. 1000 1000 1005 1000 1005 1000 1000 1012 1014 1016 1018 1020 1022 1005 1019 1040 1042 422 1044 1046 416 1016 1000 1030 1032 1034 1018 1000 1030 1032 1034 1018 1040 1042 1044 1046 1016 1050 1040 1016 illustrates a networkfor remotely controlling robotic procedures. The networkis illustrated as covering the continental United States. Another networkis illustrated as covering the continental United States, Canada, Europe, Asia, and Africa. The networkcan be a subset of the network. The networkcan be a global wide area network (WAN). The networkcan include a plurality of POP nodes,,,,, and, and the networkcan include at least a PoP node. The POP nodes can serve as regional hubs for connecting patient sites and physician sites. For instance, a plurality of sitesandeach of which houses one or more robotic systems (which can be similar to the robot) and a plurality of sitesandeach of which houses one or more physician input consoles (which can be similar to the physician input consoles) can utilize the POP nodefor connecting to the network. At the same time, a plurality of sitesandeach of which houses one or more physician input consoles and a patient sitethat houses one or more robotic systems can utilize the POP nodefor connecting to the network. As is described herein, the sites,, andcan each be connected to the POP nodevia a suitable last mile connection, and the sites,,, andcan each be connected to the POP nodevia a suitable last mile connection. For example, a last mile connectionconnects the siteto the POP node.

1000 1000 1024 1026 1028 1056 The networkcan guarantee that a physician input console located anywhere in an area, country, or region covered by the network can connect (provided that all other conditions described herein are satisfied) to a robotic system located in another part of the area, country, or region covered by the network. To achieve this, a POP node of the networkcan be connected to at least one other PoP node. Some POP nodes can be connected to multiple other PoP nodes, which can provide fallback allocation, failover, and redundancy. PoP nodes can be connected to one another by a backbone connection (or backbone network), such as,,,, or. A backbone connection can be a high-speed direct connection or a high-speed dedicated connection. A dedicated connection can be an exclusive connection that ensures consistent bandwidth and service quality (or, more generally, consistent performance). As described herein, a direct connection may not pass through any routers or switches and can provide high performance (such as, high bandwidth, low latency, low packet loss, and low jitter).

A POP node may be implemented as one or more servers, such as (such as, one or more servers housed in a data center) or can be implemented as software and/or firmware being executed by one or more processors, such as one or more processors of server(s). A data center can house one or more firewalls and one or more network switches (such as, fiberoptic network switches).

1036 1040 1052 1036 1022 1024 1022 1016 1050 1016 1040 Suppose that a physician operating a physician console located at a sitewishes to perform a remote robotic procedure on a patient using a robot located at the site. A connection between the physician console and robot can span or traverse a last mile connectionconnecting the siteto the POP node, the backbone connectionbetween POP nodesand, and the last mile connectionconnecting the POP nodeto the site.

1000 As described herein, the networkcan be an SD-WAN.

434 435 In some instances, any physician console or robot being added to the network would need to be authenticated before joining the network. Authentication can be performed using a digital certificate mechanism, such as a mechanism like that of the 802.1X protocol. For instance, a network server (such as, the connectivity serveror the NCS) can issue digital certificates that are provided to authorized physician consoles and robots and are used to join the network. When joining the network, a physician console or robot can present its digital certificate to prove its identity, and the digital certificate is validated by the server. Access to the network is granted only if the digital certificate is successfully validated. Each physician console and robot can be assigned a unique digital certificate.

Management of Remote-Controlled Robotic Procedure Systems

1000 For reliability, effectiveness, and safety of remotely controlled robotic procedures, a management system can be configured to review and, if applicable, modify the status, location, type, or other information pertaining to the robots and consoles deployed in a network (such as, the network). In an expansive network, robots and consoles from multiple distinct robotic system manufacturers may be used in multiple facilities operated by multiple distinct health systems (such as, hospitals or physician centers). For example, a robotic system manufacturer that provides multiple robots and consoles for multiple health systems may not be able to quickly identify a malfunctioning robot or console without individually reviewing the status of each robot or console in each health system. Similarly, a robotic system manufacturer may not want other robotic system manufacturers operating within the same network to be able to view information regarding its robots or consoles. As another example, an administrator for a particular health system may not have authorization to access information for robots or consoles patients located at a different healthcare facility managed by another health system.

To address these challenges, an access monitoring management system (sometimes referred to as AMMS) can be designed and deployed. Such system can support distinct groups of users for accessing various information related to the robots and consoles as well as making various changes to the robots and consoles. For example, AMMS can support three levels of users: a network administrator (“super-user”), a health system administrator, and a robotic system manufacturer. To connect to the AMMS, a requesting user may submit a request with the authorization credentials. AMS can grant access to specific robots or consoles depending on the user's authorization level. For example, robotic system manufacturer A can be granted access to all robots and consoles made by the robotic system manufacturer A. As another example, an administrator of health system A can be granted access to all robots and consoles managed by health system A regardless of the manufacturer. As yet another example, a network administrator can be granted access to all robots and consoles on the network regardless of the manufacturer or health system. In some instances, there are multiple network administrators able to access subsets of robots and consoles. For example, there can be a first network administrator that can access all robots and consoles in a first geographic region and a second network administrator that can access all robots and consoles in a second geographic region. The first network administrator may not be able access any robots or consoles in the second geographic region, and the second network administrator may not be able to access any robots or consoles in the first geographic region. Similar approach can be applied to the privileges of one or more of a health system administrator or a robotic system manufacturer. Advantageously, this approach can simplify and streamline the management of remotely controlled robotic systems.

A first set of robots and consoles that can be accessed by a robotic system manufacturer can overlap, but be different that a second set of robots or consoles that can be accessed by a health system administrator. For instance, a robotic system manufacturer A is able to access some robots in Hospital C and other robots in Hospital D, but not all robots in either Hospital C or Hospital D, which also have robots manufactured by robotic system manufacturer B.

AMMS can be implemented by one or more computers, such as one or more servers.

7 FIG.A 700 700 1000 700 702 704 706 708 710 illustrates a user interfacepresented by AMMS to the network administrator. The user interfaceprovides management information for all robots and consoles within a network (such as, the network). The user interfacecan provide device information including one or more of a device type, a device component type, device identifiers, a device status, and a device location. As is illustrated, the network administrator is presented with information for all robots and consoles on the network regardless of the manufacturer or health system.

702 712 713 The device typemay include the robot/console type and the robotic system manufacturer name. For example, a first robotis of type A and manufactured by Company A, whereas a second robotis of type C and manufactured by Company B.

704 416 422 422 The device component typecan specify whether the device is a robot or a console. The network administrator can access different data from the device depending on whether it is a robot or a console. For example, following an action by the physician on the physician input console, the network administrator can access control data generated by the console or response data transmitted by a robotto the console, which can be helpful for troubleshooting. As another example, the network administrator can access image data transmitted by the robotto the console, which can be helpful for troubleshooting.

706 706 706 The device identifierscan include name and serial number. The device identifiersmay be used to identify the make and model of the device. In some cases, the device identifiersmay be used to link the devices to other instances of the device in one or more separate databases.

708 1000 708 708 708 708 The device statusmay include the status of the device in the network. The device statusmay indicate that the device is “Online” (such as, working as intended), “Error” (such as, the device is connected to the network but is malfunctioning), or “Offline” (such as, the device is no longer connected to the network). The device statuscould be used by a user from each access level (such as, network administrator, robotic system manufacturer, or health system administrator) to quickly locate a faulty device in the network. The device statusmay also include date and time on which the device last sent a status report. For example, a device with “Offline” device status may have sent the last status report three hours earlier than a device with an “Online” device status. This may indicate to the user that the device has been disconnected from the network for at least three hours and needs attention. Indications of device statuscan be shown in different color or otherwise depicted differently for user's convenience. For instance, “Error” and “Offline” can each be shown in a different color than “Online”

719 8 FIG.A In addition to viewing the device status, control view of the device can be provided by selecting “Permissions” control(see, for example,). As described herein, control of the device can include upgrading firmware or software, making other changes to device hardware, modifying device access by a physician or operating room staff, providing various data during remote medical procedure, among others. Control view can be used for management, monitoring, and troubleshooting.

710 710 The device locationmay include the physical location of the device. The device locationmay include the health system, the specific facility within the health system, and the room number within the facility in which the device is located. For example, Health System A may include one or more facilities. Likewise, each facility may include one or more operating rooms. It may be time consuming and difficult to locate a device when a health system has multiple facilities with multiple operating rooms. In such cases, AMMS allows to quickly locate the device.

7 FIG.A 1000 1000 712 714 713 715 As described herein, in the illustrated example of, the requesting user is the network administrator. The network administrator can obtain access various health systems throughout the network. The network administrator has access to management information for all devices (irrespective of manufacturers) located at all health systems within the network. For example, the network administrator can access management information for the first robotmanufactured by Company A operated by a Health System Aand management information for the second robotmanufactured by Company B operated by Health System B.

717 The network administrator can check device status, view data generated during remote medical procedure, troubleshoot any of the devices, upgrade firmware or software, or make other changes to device hardware, among others. The network administrator may access and manage controls for the devices, such as add or modify which physicians can access which robots, control which firmware or software version the device operates on (for instance, update or modify the firmware or software version or make other changes to device hardware), or access control data, image data, log data, A/V data, or any other data generated during a remote medical procedure. The network administrator can add devices to the network via control.

712 720 720 702 704 706 708 710 720 712 714 7 FIG.B 7 FIG.B In a further example, the requesting user may be a representative of a robotic system manufacturer company, such as Company A (see the first robot).illustrates an example user interfaceprovided by AMMS for such user. In the example illustrated in, the user interfaceincludes the device type, the device component type, the device identifiers, the device status, and the device location, as described herein. The user interfacefurther includes the first robotand the first health system, as described herein.

720 700 722 722 724 712 713 7 FIG.A The user interfacecan be similar to the user interface, except that the robotic system Company A representative (such as, an administrator) is provided access to a plurality of devicesthat were manufactured by Company A. The devicesare managed by a plurality of health systems. For example, Company A representative is granted access to management information for the first robot, as it is manufactured by Company A. However, unlike the network administrator from the example in, Company A representative is not granted access to the management information for the second robot, which is manufactured by Company B. AMMS allows Company A representative to only administer the specific devices manufactured by Company A.

Robotic system manufacturer representative can have authorization to administer specific hardware manufactured by the manufacturer, such as update or modify firmware or software or make other changes to device hardware. Robotic system manufacturer representative may not have authorization to make changes beyond the scope of the representative's authorization level. For example, unlike a network administrator or health system representative, a robotic system manufacturer representative would not have authorization to change access permissions for a physician to control a robot.

717 As is illustrated, Company A representative has access to management information for devices irrespective of the health system. This specific authorization level allows for a robotic system manufacturer A to efficiently administer their devices operating within the network. Robotic system manufacturer representative can add devices to the network via control.

In some cases, the authorization level of the robotic system manufacturer A user may be further refined, such as by using sub-groups. For example, a first Company A representative may only have authorization to access management information for type “A” robots, whereas a second Company A representative may only have authorization to access management information for type “B” robots.

7 FIG.C 7 FIG.C 730 730 702 704 706 708 710 720 713 715 illustrates an example user interfacefor a Company B representative. In the example illustrated in, the user interfaceincludes the device type, the device component type, the device identifiers, the device status, and the device location, as described herein. The user interfacefurther illustrates the second robotand the Health System B, as described herein.

730 720 732 734 713 712 7 FIG.B The user interfacecan be similar to the user interface, except Company B representative is granted access to management information for a plurality of robot company B devicesmanaged by a plurality of health systems. For example, Company B representative is granted access to the management information for the second robot, as it is manufactured by Company B. However, unlike Company A representative illustrated in, representative of Company B is not able to view the management information for the first robot.

7 FIG.D 7 FIG.D 740 740 702 704 706 708 710 illustrates an example user interfaceprovided to Health System A representative (such as, administrator). In the example illustrated in, the user interfaceincludes the device type, the device component type, the device identifiers, the device status, and the device location, as described herein.

740 700 742 744 712 713 717 The user interfacecan be similar to the user interface, except that the Health System A representative is only granted access to a plurality of devicesmanaged by Health System A. For example, Health System A representative is granted access to the management information for the first robot, as it is managed by Health System A, but not the example robot, as it is managed by Health System B. By allowing Health System A representative access only to devices managed by Health System A, AMMS promotes information privacy and security among the health systems within the network. Health system administrator can add devices to the network via control.

Health system representative can have authorization to only manage the devices managed by the health system, such as update or modify firmware or software, update or modify physician access (for instance, to one or more consoles or robots), or the like, even for devices that are made by different manufacturers. In some cases, a health system representative may not have authorization to update or modify the firmware or software or make other changes to the device hardware.

In some cases, the authorization level of Health System A representative may be further refined, such as by using sub-groups. For example, a first representative from Health System A may only have authorization to access devices in facility “A” within Health System A, whereas a second representative from Health System A may only have authorization to access devices in facility “B” within Health System A.

7 FIG.E 7 FIG.E 750 750 702 704 706 708 710 720 713 715 illustrates an example user interfacefor a Health System B representative (such as, administrator). In the example illustrated in, the user interfaceincludes the device type, the device component type, the device identifiers, the device status, and the device location, as described herein. The user interfacefurther illustrates the second robotand Health System B, as described herein.

750 740 752 754 713 712 The user interfacecan be similar to the user interface, except Health System B representative is granted access only to a plurality of devicesmanaged by Health System B. For example, Health System B representative is granted access to the second robot, as it is managed by Health System B (in facility C), but not the first robot.

Health System B representative may have a similar authorization level as Health System A representative. For example, Health System B representative may only have authorization to manage devices within their health system.

As described herein, control of one or more devices can be implemented. Control can include upgrading firmware or software, making other changes to device hardware, modifying device access by a physician or operating room staff, providing various data during remote medical procedure, among others. Control view can be used for management, monitoring, and troubleshooting.

8 FIG.A 7 FIG.A 800 800 700 812 816 800 800 700 719 illustrates an example user interfacefor management and control. The user interfacecan be similar to the user interfaceofexcept that modification of one or more of access controland firmware or software version is facilitated and access to session datais provided. The user interfacecan be presented by AMMS to the network administrator and can list all robots and consoles, as described herein. The user interfacecan be brought up, for instance, by selecting a control in the user interface(such as, “Permissions”).

812 802 830 814 814 816 804 850 8 FIG.B 8 FIG.C Access controlcan facilitate changing physician access. Entries in this list can provide links (such as, a hyperlink) to bring up a separate access control user interfaceillustrated infor modifying physician access. Entries in the firmware/software update listcan be selected (such as, clicked) to update the firmware/software version. This can be facilitated by uploading a file with update version or an optional separate interface displaying all available versions. In some instances, a link or another control (such as, button) can be provided in the firmware/software update listto bring up a separate user interface for modifying firmware/software. Entries in session datalist can provide links (such as, a hyperlink) to bring up a separate session data user interfaceillustrated in.

830 832 834 836 836 840 8 FIG.B 9 FIG.A 9 FIG.B Access control user interfaceincan provide a listthat includes name(s) of allowed individual physician(s) or allowed physician group(s) for controlling a particular robot or console. As explained herein, for instance in connection with, a physician group can correspond, for instance, to those physicians who operate in the same hospital. Physician group can be is a hyperlink and can be viewed and updated. Delete actioncan be provided to remove physician access for a particular physician or physician group. Access period actioncan be provided to select type of access. For example, one option can be “always” or a time period delineated by start and end date/time for access (see). For the latter option, access period actioncan include a link clicking on which would bring up a date/time picker to edit the period. Control(such as, button) can facilitate adding new access permission, such as, adding new physician or physician group.

850 Session data user interfacecan lists every session of a particular console or robot, including, for example, one or more of start time, duration, average bandwidth, latency, packet loss, network jitter, number of instrument commands, time to second stage (e.g. time to port placement complete), and a selection (such as, a link) to display a verbose log of everything.

800 812 800 814 The user interfacepresented to a robotic system manufacturer interface can provide access controllist as read only. The user interfacepresented to a health system administrator interface can provide the firmware/software update listas read only.

9 FIG.A 900 910 920 With reference to, a user interfaceillustrates assignment of physician to physician groups, for example, by creating rules. For example, user Dr. Jon Smith may be assigned to Springfield Surgical group(along with user Dr. Cathy Snyder), and user Dr. Anne Archer may be assigned Randall Associates group(along with user Dr. Robert Thomson). For safety, it may be important that robots only permit access to physician users who are authorized to perform procedures on those robots. It can be desirable for health system administrators to be able to easily add, modify and delete access, as physician relationships change over time, without having to make requests to network admins each time. It can also be desirable to set permissions based on physician groups, so as not to require each physician permission to be added to each robot, and further to allow simpler and more organized permissions as physicians may join or leave groups over time.

900 The user interfaceprovides a robot management interface that allows health system administrators (as well as network administrators and, in some cases, robotic system manufacturers) to set physician access permissions.

9 FIG.A 910 920 910 914 920 924 shows a desired hierarchy for two robots and two physician groups. Dr. Jon Smith and Dr. Cathy Snyder belong to the Springfield Surgical group, and Dr. Anne Archer and Dr. Robert Thomson belong to the Randall Associates group. As illustrated, Springfield Surgical groupis allowed access to robot(R-XYZ-OR810), and Randall Associates groupis allowed access to robot(R-ABC-OR003). These permissions may be set by access permission rules that can be added, deleted or modified, as explained here.

9 FIG.B 9 FIG.C 950 950 914 950 800 952 954 970 924 shows a user interfacefor changing such access permission rules. The user interfacecan be accessible to the health system owning robot(R-XYZ-OR810). The user interfacecan be brought up from the user interface. Control(such as, button) can be selected for adding a new access permission rule. For example, as shown in table, Springfield Surgical is specified in the “Group or User” column, and “Always” is specified in the “Time Window” column. “Modify” and “Delete” controls (such as, buttons) are shown in “Actions” column, allowing an existing access permission rule to be edited or removed. A similar user interfaceshown incan be accessible to the health system owning robot(R-ABC-OR003).

914 With these access permission rules in place, for instance, when a request for connection from a physician at a console for controlling robot(R-XYZ-OR810) is received, such connection would be allowed if the user is in the specified group and would be disallowed if the user is not in the specified group.

It can be desirable to allow certain physicians limited-time access to a robot, for example, when they do not belong to a group that normally has access. For example, a specialty surgeon from a different health system may have unique knowledge for a particular patient case and thus may be allowed special-case access for treating that patient.

10 FIG.A 9 FIG.A 10 FIG.B 9 FIG.B 980 900 982 914 982 990 950 994 914 illustrates a user interfacethat is a modification of the user interfacein, whereby there is a direct access linedrawn from Dr. Anne Archer to robot(R-XYZ-OR810) which is outside her group. Access lineis specified as having a specific time window (November 10 6 am-5 μm).shows a user interface, which is similar to the user interfaceof, but with an additional entry where there is an entry in tablefor Dr. Anne Archer along with the specified time window. In this case, when a request for connection from a physician for controlling robot(R-XYZ-OR810) is received, such connection would be allowed if the user is in the Randall Associates group or if the user is Dr. Anne Archer and current time is within the specified time window.

In some implementations, robots can be specified as belonging to a health system. In those cases, a health system-level permission rule can be added applying automatically to access of all robots in that health system, thereby saving time of applying rules to each robot individually. Health system-level rules would be added in a different health system-level interface (not shown). Then, in the robot-level view discussed above, the applicable rule would be displayed in a highlighted color (or with some other distinction), and any attempt to edit or delete would bring up the health-system level interface.

900 In some instances, option to modify any of the settings (such as, physician access or firmware/software) would be activated by AMMS (for instance, corresponding user interface would be brought up) only if the user had the appropriate authorization level to perform the modification. For instance, the user interfacewould be displayed only to a health system administrator that has authorization to modify permissions for Springfield Surgical and Randal Associates.

Other Variations

Any of the approaches described herein can utilize any of the examples disclosed in U.S. Pat. Nos. 12,089,906, 12,064,202, U.S. application Ser. No. 19/191,839 filed on Apr. 28, 2025, U.S. application Ser. No. 19/273,503 filed on Jul. 18, 2025, U.S. application Ser. No. 19/273,545 filed on Jul. 18, 2025, U.S. application Ser. No. 19/273,589 filed on Jul. 18, 2025, each of being incorporated by reference in its entirety.

While displaying has been used to describe certain examples of outputting information, any type of visual, auditory, or tactile output can be performed in addition to or alternatively.

Any value of a threshold, limit, duration, etc. provided herein is not intended to be absolute and, thereby, can be approximate. In addition, any threshold, limit, duration, etc. provided herein can be fixed or varied either automatically or by a user. Furthermore, as is used herein relative terminology such as exceeds, greater than, less than, etc. in relation to a reference value is intended to also encompass being equal to the reference value. For example, exceeding a reference value that is positive can encompass being equal to or greater than the reference value. In addition, as is used herein relative terminology such as exceeds, greater than, less than, etc. in relation to a reference value is intended to also encompass an inverse of the disclosed relationship, such as below, less than, greater than, etc. in relations to the reference value.

Features, materials, characteristics, or groups described in conjunction with a particular aspect, implementation, or example are to be understood to be applicable to any other aspect, implementation, or example described herein unless incompatible therewith. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or all of the steps of any method or process so disclosed, can be combined in any combination, except combinations where at least some of such features and/or steps are mutually exclusive. The protection is not restricted to the details of any foregoing implementations. The protection extends to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.

While certain implementations have been described, these implementations have been presented by way of example only and are not intended to limit the scope of protection. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms. Furthermore, various omissions, substitutions and changes in the form of the methods and systems described herein may be made. Those skilled in the art will appreciate that in some cases, the actual steps taken in the processes illustrated and/or disclosed may differ from those shown in the figures. Depending on the implementation, certain of the steps described above may be removed, others may be added. For example, the actual steps and/or order of steps taken in the disclosed processes may differ from those shown in the figure. Various components illustrated in the figures or described herein may be implemented as software and/or firmware on a processor, controller, ASIC, FPGA, and/or dedicated hardware. The software or firmware can include instructions stored in a non-transitory computer-readable memory. The instructions can be executed by a processor, controller, ASIC, FPGA, or dedicated hardware. Hardware components, such as controllers, processors, ASICs, FPGAs, and the like, can include logic circuitry. Furthermore, the features and attributes of the specific examples disclosed above may be combined in different ways to form additional implementations, all of which fall within the scope of the present disclosure.

Conditional language used herein, such as, among others, “can,” “could”, “might,” “may,” “e.g.,” and the like, unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain implementation include, while other implementations do not include, certain features, elements and/or states. Thus, such conditional language is not generally intended to imply that features, elements and/or states are in any way required for one or more implementations or that one or more implementations necessarily include logic for deciding, with or without author input or prompting, whether these features, elements and/or states are included or are to be performed in any particular implementation. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Further, the term “each,” as used herein, in addition to having its ordinary meaning, can mean any subset of a set of elements to which the term “each” is applied. Additionally, the words “herein,” “above,” “below,” and words of similar import, when used in this application, refer to this application as a whole and not to any particular portions of this application.

Conjunctive language, such as the phrase “at least one of X, Y and Z,” unless specifically stated otherwise, is to be understood with the context as used in general to convey that an item, term, etc. may be either X, Y, or Z, or a combination thereof. Thus, such conjunctive language is not generally intended to imply that certain implementations require at least one of X, at least one of Y and at least one of Z to each be present.

Language of degree used herein, such as the terms “approximately,” “about,” “generally,” and “substantially” as used herein represent a value, amount, or characteristic close to the stated value, amount, or characteristic that still performs a desired function or achieves a desired result. For example, the terms “approximately”, “about”, “generally,” and “substantially” may refer to an amount that is within less than 10% of, within less than 5% of, within less than 1% of, within less than 0.1% of, or within less than 0.01% of the stated value.

Unless otherwise explicitly stated, articles such as “a” or “an” should generally be interpreted to include one or more described items. Accordingly, phrases such as “a device configured to” are intended to include one or more recited devices. Such one or more recited devices can also be collectively configured to carry out the stated recitations.

While specific implementations have been described and illustrated, such implementations should be considered illustrative only and not as limiting. Accordingly, the scope of the present disclosure is not intended to be limited by the specific disclosures of preferred implementations herein, and may be defined by claims as presented herein or as presented in the future.

Examples of the implementations of the present disclosure can be described in view of the following example clauses. The features recited in the below example implementations can be combined with additional features disclosed herein. Furthermore, additional inventive combinations of features are disclosed herein, which are not specifically recited in the below example implementations, and which do not include the same features as the specific implementations below. For sake of brevity, the below example implementations do not identify every inventive aspect of this disclosure. The below example implementations are not intended to identify key features or essential features of any subject matter described herein. Any of the example clauses below, or any features of the example clauses, can be combined with any one or more other example clauses, or features of the example clauses or other features of the present disclosure.

Clause 1. A system for remotely controlling robotic medical procedures, the system including: a plurality of physician consoles, each physician console configured to: transmit control data to a patient-side robotic procedure system of a plurality of patient-side robotic procedure systems to cause the patient-side robotic procedure system to control one or more of at least one instrument or at least one imaging system, the plurality of physician consoles located remotely from the plurality of patient-side robotic procedure systems, the plurality of patient-side robotic procedure systems, each robotic procedure system configured to: receive control data and use the control data to control one or more of at least one instrument or at least one imaging system; and transmit image data obtained by the at least one imaging system to a physician console, wherein the plurality of physician consoles and the plurality of patient-side robotic procedure systems include physician consoles and robotic procedures systems of different manufacturer types and being administered by different entities; and at least one non-transitory computer readable medium storing instructions that, when executed at least one processor, cause the at least one processor to: monitor status of the plurality of physician consoles and the plurality of patient-side robotic procedure systems; receive a first request for status of a physician console or a patient-side robotic procedure system; in response receiving the first request for status, determine an authorization level associated with the first request; in response to determining that the authorization level associated with the first request corresponds to a first authorization level that provides access to status of any physician console or any patient-side robotic procedure system, provide status of the physician console or the patient-side robotic procedure system; in response to determining that the authorization level associated with the first request corresponds to a second authorization level that provides access to status of any physician console of a particular manufacturer type or any patient-side robotic procedure system of the particular manufacturer type: determine a manufacturer type of the physician console or the patient-side robotic procedure system; in response to determining that the manufacturer type of the physician console or the patient-side robotic procedure system matches the particular manufacturer type, provide status of the physician console or the patient-side robotic procedure system; and in response to determining that the manufacturer type of the physician console or the patient-side robotic procedure system does not match the particular manufacturer type, reject provision of status of the physician console or the patient-side robotic procedure system; and in response to determining that the authorization level associated with the first request corresponds to a third authorization level that provides access to status of any physician console or any patient-side robotic procedure system administered by a particular entity: determine an entity administering the physician console or the patient-side robotic procedure system; in response to determining that the entity administering the physician console or the patient-side robotic procedure system matches the particular entity, provide status of the physician console or the patient-side robotic procedure system; and in response to determining that the entity administering the physician console or the patient-side robotic procedure system does not match the particular entity, reject provision of status of the physician console or the patient-side robotic procedure system. The second authorization level and the third authorization level can define a plurality of independent sets of one or more of physician consoles or patient-side robotic procedure systems. A first set associated with the second authorization level can include 1) at least one first physician console or patient-side robotic system that is also included in a second set associated with the third authorization level and 2) at least one second physician console or patent-side robotic system that is not included in the second set.

Clause 2. The system of clause 1, wherein the instructions further cause the at least one processor to: receive a second request to update firmware or software of a physician console or a patient-side robotic procedure system; and in response receiving the second request: determine an authorization level associated with the second request; and in response to determining that the authorization level associated with the second request corresponds to the first or second authorization level, update firmware or software of the physician console or a patient-side robotic procedure system.

Clause 3. The system of clause 2, wherein the instructions further cause the at least one processor to, in response receiving the second request: in response to determining that the authorization level associated with the second request corresponds to the third authorization level, disallow update of firmware or software of the physician console or a patient-side robotic procedure system.

Clause 4. The system of any one of clauses 1 to 3, wherein the instructions further cause the at least one processor to: in response a second request to modify physician access to a physician console or a patient-side robotic procedure system: determine an authorization level associated with the second request; in response to determining that the authorization level associated with the second request corresponds to the first authorization level, modify physician access to the physician console or the patient-side robotic procedure system; and in response to determining that the authorization level associated with the second request corresponds to the third authorization level: determine an entity administering the physician console or the patient-side robotic procedure system; in response to determining that the entity administering the physician console or the patient-side robotic procedure system matches the particular entity, modify physician access to the physician console or the patient-side robotic procedure system; and in response to determining that the entity administering the physician console or the patient-side robotic procedure system does not match the particular entity, not modify physician access to the physician console or the patient-side robotic procedure system.

Clause 5. The system of clause 4, wherein the instructions further cause the at least one processor to: in response to the second request: in response to determining that the authorization level associated with the second request corresponds to the second authorization level, disallow modification of physician access to the physician console or a patient-side robotic procedure system.

Clause 6. The system of any one of clauses 1 to 5, wherein: the first set includes one or more first physician consoles and patient-side robotic procedure systems of a first manufacturer type and a second set includes one or more second physician consoles and patient-side robotic procedure systems of the first manufacturer type; the first set is administered by a first entity; and the second set is administered by a second entity different from the first entity.

Clause 7. The system of any one of clauses 1 to 6, wherein: a set of one or more first physician consoles and patient-side robotic procedure systems administered by a first entity includes physician consoles and patient-side robotic procedure systems of different manufacturer types.

Clause 8. The system of any one of clauses 1 to 7, wherein: the first authorization level allows access to any physician console of the plurality of physician consoles or any patient-side robotic procedure system of the plurality of patient-side robotic procedure systems; the second authorization level allows access to only those physician consoles or those patient-side robotic procedure systems that are manufactured by a particular manufacturer; and the third authorization level allows access to only those physician consoles or those patient-side robotic procedure systems that are administered by a particular healthcare entity.

Clause 9. A method for remotely controlling robotic medical procedures, the method including: by at least one processor: monitoring status of a plurality of physician consoles and a plurality of patient-side robotic procedure systems, wherein: each physician console is configured to: transmit control data to a patient-side robotic procedure system of a plurality of patient-side robotic procedure systems to cause the patient-side robotic procedure system to control one or more of at least one instrument or at least one imaging system, the plurality of physician consoles located remotely from the plurality of patient-side robotic procedure systems; and each robotic procedure system is configured to: receive control data and use the control data to control one or more of at least one instrument or at least one imaging system; and transmit image data obtained by the at least one imaging system to a physician console, wherein the plurality of physician consoles and the plurality of patient-side robotic procedure systems include physician consoles and robotic procedures systems of different manufacturer types and being administered by different entities; receiving a first request for status of a physician console or a patient-side robotic procedure system; responsive receiving the first request for status, determining an authorization level associated with the first request; at a first time: responsive to determining that the authorization level associated with the first request corresponds to a first authorization level that provides access to status of any physician console or any patient-side robotic procedure system, providing status of the physician console or the patient-side robotic procedure system; at a second time: responsive to determining that the authorization level associated with the first request corresponds to a second authorization level that provides access to status of any physician console of a particular manufacturer type or any patient-side robotic procedure system of the particular manufacturer type: determining a manufacturer type of the physician console or the patient-side robotic procedure system; at a third time, responsive to determining that the manufacturer type of the physician console or the patient-side robotic procedure system matches the particular manufacturer type, providing status of the physician console or the patient-side robotic procedure system; and at a fourth time, responsive to determining that the manufacturer type of the physician console or the patient-side robotic procedure system does not match the particular manufacturer type, rejecting provision of status of the physician console or the patient-side robotic procedure system; and at a fifth time: responsive to determining that the authorization level associated with the first request corresponds to a third authorization level that provides access to status of any physician console or any patient-side robotic procedure system administered by a particular entity: determining an entity administering the physician console or the patient-side robotic procedure system; at a sixth time, responsive to determining that the entity administering the physician console or the patient-side robotic procedure system matches the particular entity, providing status of the physician console or the patient-side robotic procedure system; and at a seventh time, responsive to determining that the entity administering the physician console or the patient-side robotic procedure system does not match the particular entity, rejecting provision of status of the physician console or the patient-side robotic procedure system. The second authorization level and the third authorization level can define a plurality of independent sets of one or more of physician consoles or patient-side robotic procedure systems. A first set associated with the second authorization level can include 1) at least one first physician console or patient-side robotic system that is also included in a second set associated with the third authorization level and 2) at least one second physician console or patent-side robotic system that is not included in the second set.

Clause 10. The method of clause 9, further including: receiving a second request to update firmware or software of a physician console or a patient-side robotic procedure system; and responsive receiving the second request: determining an authorization level associated with the second request; and at an eight time, responsive to determining that the authorization level associated with the second request corresponds to the first or second authorization level, updating firmware or software of the physician console or a patient-side robotic procedure system.

Clause 11. The method of clause 10, further including responsive to receiving the second request: at a ninth time: determining that the authorization level associated with the second request corresponds to the third authorization level; and responsive to determining that the authorization level associated with the second request corresponds to the third authorization level, disallowing update of firmware or software of the physician console or a patient-side robotic procedure system.

Clause 12. The method of any one of clauses 9 to 11, further including: responsive to a second request to modify physician access to a physician console or a patient-side robotic procedure system: determining an authorization level associated with the second request; at an eight time, responsive to determining that the authorization level associated with the second request corresponds to the first authorization level, modifying physician access to the physician console or the patient-side robotic procedure system; and at a ninth time, responsive to determining that the authorization level associated with the second request corresponds to the third authorization level: determining an entity administering the physician console or the patient-side robotic procedure system; at a tenth time, responsive to determining that the entity administering the physician console or the patient-side robotic procedure system matches the particular entity, modifying physician access to the physician console or the patient-side robotic procedure system; and at an eleventh time, responsive to determining that the entity administering the physician console or the patient-side robotic procedure system does not match the particular entity, not modifying physician access to the physician console or the patient-side robotic procedure system.

Clause 13. The method of clause 12, further including: responsive to the second request: at a twelfth time, responsive to determining that the authorization level associated with the second request corresponds to the second authorization level, disallowing modification of physician access to the physician console or a patient-side robotic procedure system.

Clause 14. The method of any one of clauses 9 to 13, wherein: the first set includes one or more first physician consoles and patient-side robotic procedure systems of a first manufacturer type and a second set includes one or more second physician consoles and patient-side robotic procedure systems of the first manufacturer type; the first set is administered by a first entity; and the second set is administered by a second entity different from the first entity.

Clause 15. The method of any one of clauses 9 to 14, wherein: a set of one or more first physician consoles and patient-side robotic procedure systems administered by a first entity includes physician consoles and patient-side robotic procedure systems of different manufacturer types.

Clause 16. The method of any one of clauses 9 to 15, wherein: the first authorization level allows access to any physician console of the plurality of physician consoles or any patient-side robotic procedure system of the plurality of patient-side robotic procedure systems; the second authorization level allows access to only those physician consoles or those patient-side robotic procedure systems that are manufactured by a particular manufacturer; and the third authorization level allows access to only those physician consoles or those patient-side robotic procedure systems that are administered by a particular healthcare entity.

Clause 17. A non-transitory computer readable medium storing instructions that, when executed at least one processor, cause the at least one processor to: monitor status of a plurality of physician consoles and a plurality of patient-side robotic procedure systems, wherein: each physician console is configured to: transmit control data to a patient-side robotic procedure system of a plurality of patient-side robotic procedure systems to cause the patient-side robotic procedure system to control one or more of at least one instrument or at least one imaging system, the plurality of physician consoles located remotely from the plurality of patient-side robotic procedure systems; and each robotic procedure system is configured to: receive control data and use the control data to control one or more of at least one instrument or at least one imaging system; and transmit image data obtained by the at least one imaging system to a physician console, wherein the plurality of physician consoles and the plurality of patient-side robotic procedure systems include physician consoles and robotic procedures systems of different manufacturer types and being administered by different entities; receive a first request for status of a physician console or a patient-side robotic procedure system; in response receiving the first request for status, determine an authorization level associated with the first request; in response to determining that the authorization level associated with the first request corresponds to a first authorization level that provides access to status of any physician console or any patient-side robotic procedure system, provide status of the physician console or the patient-side robotic procedure system; in response to determining that the authorization level associated with the first request corresponds to a second authorization level that provides access to status of any physician console of a particular manufacturer type or any patient-side robotic procedure system of the particular manufacturer type: determine a manufacturer type of the physician console or the patient-side robotic procedure system; in response to determining that the manufacturer type of the physician console or the patient-side robotic procedure system matches the particular manufacturer type, provide status of the physician console or the patient-side robotic procedure system; and in response to determining that the manufacturer type of the physician console or the patient-side robotic procedure system does not match the particular manufacturer type, reject provision of status of the physician console or the patient-side robotic procedure system; and in response to determining that the authorization level associated with the first request corresponds to a third authorization level that provides access to status of any physician console or any patient-side robotic procedure system administered by a particular entity: determine an entity administering the physician console or the patient-side robotic procedure system; in response to determining that the entity administering the physician console or the patient-side robotic procedure system matches the particular entity, provide status of the physician console or the patient-side robotic procedure system; and in response to determining that the entity administering the physician console or the patient-side robotic procedure system does not match the particular entity, reject provision of status of the physician console or the patient-side robotic procedure system. The second authorization level and the third authorization level can define a plurality of independent sets of one or more of physician consoles or patient-side robotic procedure systems. A first set associated with the second authorization level can include 1) at least one first physician console or patient-side robotic system that is also included in a second set associated with the third authorization level and 2) at least one second physician console or patent-side robotic system that is not included in the second set.

Clause 18. The non-transitory computer readable medium of clause 17, wherein the instructions further cause the at least one processor to: receive a second request to update firmware or software of a physician console or a patient-side robotic procedure system; and in response to receiving the second request: determine an authorization level associated with the second request; and in response to determining that the authorization level associated with the second request corresponds to the first or second authorization level, update firmware or software of the physician console or a patient-side robotic procedure system.

Clause 19. The non-transitory computer readable medium of clause 18, wherein the instructions further cause the at least one processor to: in response receiving the second request: in response to determining that the authorization level associated with the second request corresponds to the third authorization level, disallow update of firmware or software of the physician console or a patient-side robotic procedure system.

Clause 20. The non-transitory computer readable medium of any one of clauses 17 to 19, wherein the instructions further cause the at least one processor to: in response a second request to modify physician access to a physician console or a patient-side robotic procedure system: determine an authorization level associated with the second request; in response to determining that the authorization level associated with the second request corresponds to the first authorization level, modify physician access to the physician console or the patient-side robotic procedure system; and in response to determining that the authorization level associated with the second request corresponds to the third authorization level: determine an entity administering the physician console or the patient-side robotic procedure system; in response to determining that the entity administering the physician console or the patient-side robotic procedure system matches the particular entity, modify physician access to the physician console or the patient-side robotic procedure system; and in response to determining that the entity administering the physician console or the patient-side robotic procedure system does not match the particular entity, not modify physician access to the physician console or the patient-side robotic procedure system.

Clause 21. The non-transitory computer readable medium of clause 20, wherein the instructions further cause the at least one processor to: in response to receiving the second request: in response to determining that the authorization level associated with the second request corresponds to the second authorization level, disallow modification of physician access to the physician console or a patient-side robotic procedure system.